Elise Dobson Ezelle, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

3639G Issued in AL

Practice address

2617 7TH St
Tuscaloosa, AL 35401-1803

Phone

(205) 860-5113

NPI assigned

Sep 21, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New Perspectives Counseling & Consulting, LLC

  • Clinical Social Worker
  • Tuscaloosa, AL
  • NPI 1548827694
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1952952913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 7TH ST",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354011803",
            "telephone_number": "205-860-5113",
            "fax_number": "205-882-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 7TH ST",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354011803",
            "telephone_number": "205-860-5113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZELLE",
        "first_name": "ELISE",
        "middle_name": "DOBSON",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-21",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "5021C",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AL",
            "license": "3639G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://secure.simplepractice.com",
            "affiliation": "N",
            "endpointDescription": "Simple Practice Software",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "software",
            "address_1": "3200 Clements Rd",
            "city": "Cottondale",
            "state": "AL",
            "country_code": "US",
            "postal_code": "354532137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Excel Anesthesia
• Eyecare Associates, Inc.
• Eyeglasses Services on Wheels
• Eyemart Express LLC
• Eyemart Express, LTD.
• F.O.C.U.S. of West Alabama, LLC
• Alla Fabrikant, PHARMD
• Andrew Robert Fadool, MD
• William Edward Fagan, MD
• Andrea Teresa Fair, M.D.

• Social Worker in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.